Many seniors today say that they would prefer to stay in their homes, or “age in place,” for as long as possible. But as people get older, a number of age-related conditions can make living at home increasingly difficult. Challenges like cognitive decline and decreased mobility can make living at home without assistance difficult and unsafe.
In-home care can make aging in place much safer for most seniors, especially when used in tandem with home modifications and assistive technology. In-home care aides can provide the personal care assistance, companionship, and monitoring that one would receive in a long-term care community while allowing them to remain in the comfort of their own homes. Home care offers the best of both worlds for seniors who need assistance but are not ready to move to a residential care community, which may be part of the reason why millions of Americans use in-home care services each year.
We’ve created this guide to help you better understand home care services and navigate the caregiver hiring process. Below, you’ll find detailed information on the types of home care, how much home care costs and how to pay for it, signs it’s time for in-home care, and how to find the best provider for your loved one.
What Is In-Home Care?
In-home care, also known as home care, is nonmedical care provided in the client’s home. It includes custodial care for elderly people and assistance with activities of daily living (ADLs) such as eating, bathing, and providing medication reminders. Home care aides also provide companionship, socialization, and cognitive stimulation for seniors. Family caregivers oftentimes use home care services as a respite when they need to travel, work, or attend to other personal errands.
The assistance of home care aides allows many elderly adults to remain at home when they are not ready to relocate to a residential care community. It’s also a good option for those who just need some assistance and are otherwise independent, as the amount of care can be personalized for each individual’s needs, from one afternoon per week to 24 hours a day, seven days a week.
What Are the Different In-Home Care Options?
There are different types of in-home care to accommodate elderly adults with different needs. The levels of care span from basic companionship and light housekeeping to skilled medical care administered by specially-trained home health care aides. Below, we break down in-home care into three main categories.
(1) Companion Care Services
Companion care providers do just what the name says: provide company for older adults, especially those who are isolated at home because of frailty, cognitive impairments (such as mild- to moderate-stage Alzheimer’s disease), or because they live alone.
Sometimes called “elder companions,” these aides keep a watchful eye, drive clients to appointments, safeguard someone unsteady on his or her feet, read aloud, play cards, prepare light meals and snacks, and otherwise function as an extra set of hands, eyes, and feet for your loved one.
Companion care is ideal for someone who would otherwise have to spend part of the day alone and who requires some light assistance. Companion care also provides a valuable social benefit, decreasing isolation and improving mood. Warm relationships are often formed when a consistent companion is on the job.
(2) Personal Care Assistance
In addition to providing companion care, home care aides offer assistance with all kinds of activities of daily living, from grocery shopping to non-medical personal care like toileting, dressing, grooming, and bathing. They can also provide temporary respite care for families.
Many families enlist personal care assistants to solve problems in their home care situation, such as a small woman hiring a strong aide who can lift a spouse for bathing, or a son concerned about privacy hiring a woman to bathe his mother. Personal care assistants can also fill a need for seniors who are starting to have difficulties maintaining their home or completing all ADLs independently, but who do not yet need the full-time assistance available at an assisted living community.
In addition to assistance with ADLs, personal care assistants can arrange for meal preparation, escorts to doctor visits, and any other type of nonmedical assistance your loved one may need in order to live at home longer. If you need to get away for a few hours a week or overnight, in-home care can ease the worry, especially if the in-home caregiver is familiar to your loved one because he or she provides regular services.
(3) Home Health Care
Home health care is a type of in-home care that involves higher-level medical care and therapy. Unlike personal care assistants, who are not able to perform any medical care, home health aides must undergo specialized training and/or have a nursing degree or certification to perform skilled nursing tasks such as administering injections, maintaining oxygen tubes and catheters, and conducting physical or occupational therapy.
Note that home health care is the only type of home care that involves skilled nursing or therapy services. Standard home care does not include any type of medical services. Those in need of skilled nursing care, medication administration, or physical or occupational therapy should look into home health care rather than regular home care.
What Are Some Signs That It May Be Time for In-Home Care?
(1) Decreased Mobility
Trouble walking and moving around can make it tough to complete routine activities of daily living, making in-home care a much-needed help. Mobility issues can have far-reaching effects, making it tough to safely get around the house (especially if stairs are involved), shower, or go out for errands and social visits. This can lead to a host of other problems, from fall-related injuries to malnutrition. Home caregivers can help your loved one get where they need to go and provide valuable companionship.
(2) A Decline in Hygiene and Grooming
One of the biggest indicators that your aging parent needs in-home help is a noticeable decline in hygiene and grooming. This may include infrequent bathing, overgrown facial hair, or a generally unkempt appearance. Typically hygiene and grooming habits decline when a person is no longer able to keep up with these routines, either physically or due to cognitive impairments.
Maintaining one’s hygiene and grooming is considered an activity of daily living, and many people work with a home care provider to help their loved one with these tasks. Personal care assistance can both physically help a client complete their ADLs as well as help a person stick to a more regular routine and grooming schedule. In-home care aides can also help with other hygiene-related ADLs including toileting and bathing.
(3) Physical Changes
When you give your loved one a hug, you may notice that they feel thinner and frailer than before. Or, maybe you’ve spotted bruises on their body. These types of physical symptoms may be signs that your parent needs some extra help at home. Significant weight loss can be a sign that your aging parent is struggling to prepare meals for themselves, or that they have trouble getting around the kitchen or possibly remembering how to cook properly (a sign of cognitive decline).
Bruises tend to be evidence of falls or other accidents, although your loved one may be reluctant to admit that this is happening. An in-home caregiver can help ensure that your parent is getting the proper nutrition and can help them prevent falls.
(4) Increased Forgetfulness
We all forget things sometimes – the name of that book you read, or whatever it is you walked into the room to get. But increasing incidents of forgetfulness over time, especially when it comes to important to-dos like taking medication or paying bills, may indicate that home care help is needed. If your loved one’s memory issues are interfering with their everyday activities and well-being, it’s a good indication that they should see a physician about their memory problems, as these may be signs of cognitive decline. Working with an in-home care assistant, you can help ensure that your loved one stays on top of their normal activities, despite any cognitive decline.
(5) Difficulty Maintaining One’s Home
Difficulty keeping up with housework is a common indication that an elderly person needs in-home assistance. They may be unable to perform these tasks the way they did before due to mobility issues, cognitive decline, or even depression.
Some signs that your loved one is struggling to keep up with the housework may include dust, dirt, or grime in areas that used to be clean, excessive clutter, or piles of dirty dishes. Many in-home caregivers provide housekeeping assistance such as cleaning countertops and appliances, sweeping the floor, running the dishwasher, and doing laundry.
(6) Loss of Interest in Activities and Hobbies
Have you noticed that your loved one no longer seems to enjoy many of the hobbies they once loved? Maybe their previously well-tended backyard garden has been neglected, or their weekly card game with friends has gone by the wayside. You might notice that your mom or dad has even given up more sedentary activities such as knitting, reading, or watching a favorite TV show.
Losing interest in hobbies and activities can be a sign of numerous underlying problems, notably depression. While an in-home caregiver won’t be able to solve these medical or mental health issues, they can help ensure that your loved one adheres to treatment plans, has regular social interaction and companionship, and can provide much-needed help so that your mom or dad is still able to enjoy favorite pastimes.
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Source: Senior Advice
Additional Resources: Guides to Affordable Health Insurance